The American Academy of Neurology (AAN) has issued a new guideline determining that the widely used transcutaneous electric nerve stimulation (TENS) method of pain therapy is not recommended to treat chronic low-back pain (pain that has persisted for three months or longer). Research shows that TENS is not effective, according to AAN. The guideline is published in the December 30, 2009, online issue of AAN's medical journal, Neurology.

TENS, a treatment of neurologic and other disorders that has been in use for several decades, involves applying electrical impulses to areas of the body through a portable device that modulates pulse width, frequency and intensity of the impulses.

In the guideline "Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review)," the authors say the way TENS works on pain is not expressly known, but the rationale is predicated on the gate control theory. The guideline discusses review of clinical trials of TENS compared to placebo or other therapies for painful neurologic conditions. The studies included for review had conflicting evidence regarding the efficacy of TENS for chronic low back pain. In two Class I studies no benefit was found; in two Class II studies a modest benefit was found, and a third Class II study showed no benefit. The authors of the guideline stated that the Class I provided stronger evidence, so TENS is established as ineffective for the treatment of chronic low back
pain.

"The strongest evidence showed that there is no benefit for people using TENS for chronic low-back pain," said guideline author Richard M. Dubinsky, M.D., M.P.H., of Kansas University Medical Center in Kansas City and a Fellow of the American Academy of Neurology, in an AAN press release. "Doctors should use clinical judgment regarding TENS use for chronic low-back pain. People who are currently using TENS for their low-back pain should discuss these findings with their doctors." However, Dubinsky noted that good evidence demonstrates that TENS can be effective in treating diabetic nerve pain.

Adapted in part from an AAN press release.
Read more and get links:
http://www.aan.com/globals/axon/assets/6722.pdf

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